Vitiligo

Vitiligo is a chronic condition that causes patches of skin to lose their pigment, resulting in irregular white patches of skin. It occurs when melanocytes, the cells responsible for skin pigmentation, are destroyed or stop functioning. The condition can affect people of any age, gender, or ethnicity, and is more noticeable in individuals with darker skin. While the exact cause is unknown, vitiligo is generally considered to be an autoimmune condition. The extent and rate of colour loss from vitiligo is often challenging to predict.

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Key Points

What is vitiligo?

Vitiligo is a skin condition where patches of skin lose their normal pigment and become white due to the loss of melanocytes. It’s not contagious or life-threatening, but it can significantly impact a person’s appearance and self-esteem.

Who gets vitiligo?

Vitiligo can affect anyone, but it often starts before the age of 20. There’s no clear gender or racial bias, although it may be more noticeable in people with darker skin. The condition may be linked to a family history of vitiligo or other autoimmune diseases.

Clinical features

Vitiligo is characterised by white patches on the skin that can vary in size and location. These patches are more common in areas exposed to the sun, skin folds, and near body openings. Hair growing in affected areas may also turn white.

Diagnosis and differential diagnosis

Vitiligo is diagnosed based on the characteristic appearance of the skin. A Wood’s lamp examination and skin biopsy can confirm the diagnosis. It’s important to differentiate vitiligo from other conditions causing skin depigmentation, like chemical leukoderma and hypopigmentation disorders.

Impact and complications

While vitiligo is not physically or medically harmful, it can have significant psychological and emotional impacts, especially in darker-skinned individuals. Vitiligo can be associated with other autoimmune problems such as autoimmune thyroid disorders. 

Treatment Options for Vitiligo

The treatment of vitiligo focuses on restoring skin colour or uncommonly, removing remaining colour. Topical treatments involve corticosteroids, calcineurin or JAK inhibitors to restore pigment. Phototherapy uses UVB light to stimulate melanocyte function. In severe cases, depigmentation involves removing remaining pigment. Surgery, such as skin grafting, is used in small areas in stable and segmental vitiligo. Lifestyle adjustments include sun protection and the use of cosmetics to camouflage depigmented skin. The effectiveness of treatment varies, and complete repigmentation may not be possible.

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